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Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit

Agha, Riaz A. M.B.B.S., M.Sc.(Oxf.); Pidgeon, Thomas E. M.B.Ch.B.; Borrelli, Mimi R. M.B.B.S.; Dowlut, Naeem B.Sc.(Hons.); Orkar, Ter-Er K. M.B.Ch.B.; Ahmed, Maziyah B.Sc.; Pujji, Ojas; Orgill, Dennis P. M.D., Ph.D.; for the VOGUE Group


The May 2018 Breast article entitled “Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit” ( Plast Reconstr Surg . 2018;141:633e-638e) should have included Supplemental Digital Content. The last sentence of the Results of paragraph, on page 635e, should read, “The nine criteria that met consensus constitute the VOGUE core outcome set ( see Figure, Supplemental Digital Content 1 , which shows the nine criteria, ).”

Plastic and Reconstructive Surgery. 142(1):295, July 2018.

Plastic and Reconstructive Surgery: May 2018 - Volume 141 - Issue 5 - p 633e-638e
doi: 10.1097/PRS.0000000000004273
Breast: Original Articles

Background: Autologous fat grafting is an important part of the reconstructive surgeon’s toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors’ group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors’ goal was to develop a core outcome set for autologous fat grafting in breast reconstruction.

Methods: The authors published their protocol a priori. A Delphi consensus exercise among key stakeholders was conducted using a list of outcomes generated from their previous work. These outcomes were divided into six domains: oncologic, clinical, aesthetic and functional, patient-reported, process, and radiologic.

Results: In the first round, 55 of 78 participants (71 percent) completed the Delphi consensus exercise. Consensus was reached on nine of the 13 outcomes. The clarity of the results and lack of additional suggested outcomes deemed further rounds to be unnecessary.

Conclusions: The VOGUE Study has led to the development of a much-needed core outcome set in the active research front and clinical area of autologous fat grafting. The authors hope that clinicians will use this core outcome set to audit their practice, and that researchers will implement these outcomes in their study design and reporting of autologous fat grafting outcomes. The authors encourage journals and surgical societies to endorse and encourage use of this core outcome set to help refine the scientific quality of the debate, the discourse, and the literature.


East Grinstead, Birmingham, London, Liverpool, and Nottingham, United Kingdom; and Boston, Mass.

From the Department of Plastic Surgery, Queen Victoria Hospital NHS Foundation Trust; the Department of Plastic Surgery and Burns, Birmingham Children’s Hospital; the Department of Plastic Surgery, Guy’s and St. Thomas’ NHS Foundation Trust; Barts and The London School of Medicine and Dentistry; the University of Liverpool; the University of Nottingham; the College of Medical and Dental Sciences, University of Birmingham; and the Division of Plastic Surgery, Brigham and Women’s Hospital.

Received for publication September 13, 2017; accepted November 21, 2017.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work.

Naeem Dowlut, B.Sc.(Hons.), Barts and The London School of Medicine, Turner Street, Whitechapel, London E1 2AD, United Kingdom,

Copyright © 2018 by the American Society of Plastic Surgeons